Prevalence of chronic kidney disease in China: a cross-sectional survey
Prevalence of chronic kidney disease in China: a cross-sectional survey
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DOI：
10.1016/s0140-6736(12)60033-6
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发表时间：
2012-03-03
期刊：
影响因子：
168.9
通讯作者：
Wang, Haiyan
中科院分区：
文献类型：
--
作者：
Zhang, Luxia;Wang, Fang;Wang, Haiyan
在发展中国家，慢性肾脏疾病的患病率很高。然而，在中国这样一个经济多样化的发展中国家，还没有对慢性肾脏疾病进行全国性的调查，包括肾小球滤过率（eGFR）和蛋白尿的估计。我们的目的是通过这样的调查来衡量中国慢性肾脏疾病的患病率。方法我们对具有全国代表性的中国成年人样本进行了横断面调查。慢性肾脏疾病定义为eGFR低于60ml /min / 1.73 m(2)或存在蛋白尿。参与者完成了一份生活方式和病史问卷，测量了他们的血压，并采集了血液和尿液样本。测定血清肌酐并用于估计肾小球滤过率。检测尿白蛋白和肌酐以评估蛋白尿。计算肾脏损害指标的原始患病率和调整患病率，并通过logistic回归分析与慢性肾脏疾病存在相关的因素。调查结果50550人被邀请参加，其中47204人同意。eGFR低于60 mL/min / 1.73 m(2)的校正患病率为1.7% (95% CI 1.5-1.9)，蛋白尿的校正患病率为9.4%（8.9-10.0）。慢性肾脏疾病的总患病率为10.8% (10.2-11.3)；因此，中国慢性肾脏疾病患者人数估计约为1.195亿（1.129 - 1.25亿）。在农村地区，经济发展与蛋白尿的存在独立相关。与其他地区相比，慢性肾脏疾病的患病率在北方（16.9%[15.1-18.7]）和西南（18.3%[16.4-20.4]）较高。与肾损害独立相关的其他因素有年龄、性别、高血压、糖尿病、心血管病史、高尿酸血症、居住地区和经济状况。慢性肾脏疾病已成为中国一个重要的公共卫生问题。应特别关注中国经济发展较好的农村地区和特定地理区域的居民。
Background The prevalence of chronic kidney disease is high in developing countries. However, no national survey of chronic kidney disease has been done incorporating both estimated glomerular filtration rate (eGFR) and albuminuria in a developing country with the economic diversity of China. We aimed to measure the prevalence of chronic kidney disease in China with such a survey.Methods We did a cross-sectional survey of a nationally representative sample of Chinese adults. Chronic kidney disease was defined as eGFR less than 60 mL/min per 1.73 m(2) or the presence of albuminuria. Participants completed a lifestyle and medical history questionnaire and had their blood pressure measured, and blood and urine samples taken. Serum creatinine was measured and used to estimate glomerular filtration rate. Urinary albumin and creatinine were tested to assess albuminuria. The crude and adjusted prevalence of indicators of kidney damage were calculated and factors associated with the presence of chronic kidney disease analysed by logistic regression.Findings 50 550 people were invited to participate, of whom 47 204 agreed. The adjusted prevalence of eGFR less than 60 mL/min per 1.73 m(2) was 1.7% (95% CI 1.5-1.9) and of albuminuria was 9.4% (8.9-10.0). The overall prevalence of chronic kidney disease was 10.8% (10.2-11.3); therefore the number of patients with chronic kidney disease in China is estimated to be about 119.5 million (112.9-125.0 million). In rural areas, economic development was independently associated with the presence of albuminuria. The prevalence of chronic kidney disease was high in north (16.9% [15.1-18.7]) and southwest (18.3% [16.4-20.4]) regions compared with other regions. Other factors independently associated with kidney damage were age, sex, hypertension, diabetes, history of cardiovascular disease, hyperuricaemia, area of residence, and economic status.Interpretation Chronic kidney disease has become an important public health problem in China. Special attention should be paid to residents in economically improving rural areas and specific geographical regions in China.